Colorectal cancer is the fourth leading cancer and the second leading cause of death in the United States, although mortality rates have been declining through screening and improved treatment methods.
Dr. Stephen Makoni, hematologist/oncologist for Trinity Health, explained that in the Minot area there were 60 people diagnosed with colorectal cancers in 2008. That makes colorectal cancer one of the top four cancers diagnosed in area residents.
But people can take preventive measures against colorectal cancer, and regular screenings can help catch the cancer at a treatable stage. Colorectal cancer is highly treatable, Makoni explained, if it's caught early.
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Katina Tengesdal/MDN - - Dr. Stephen Makoni, hematologist/oncologist for Trinity Health, discussed treatment updates and prevention strategies for colorectal cancer.
"Colon cancer tends to be associated with polyps that form over a long period of time before they turn to cancer. If you can remove the polyps, you can prevent cancer," Makoni said.
Screening
He said patients diagnosed with colorectal cancer have been found to be cancer free after five years at percentage rates of 93 percent for stage one cancers, 40 to 60 percent for stage 3, and 8 percent for stage 4; making early detection important.
"We have different screening methods for detection, and the most used is colonoscopy," Makoni said. "The benefit of colonoscopy is that we can do a biopsy at the same time if anything abnormal is found, but people may not like it because it's invasive and you need to take laxatives to clean the bowel before the procedure."
"CT colonography is becoming available, and those are CT scans that do the same thing as colonoscopy," he said. "The problem is you're being exposed to a lot of radiation during the scan, but it is less invasive. And if anything abnormal is found, we still need to do a colonoscopy to do a biopsy."
In addition to those tests, other tests are available that check for blood in the stool or for DNA changes in cells found in stool.
Guidelines
People should get a colonoscopy after age 50, Makoni said. But those who have had a first-degree relative diagnosed with colorectal cancer should begin screenings 10 years before the age that their youngest family member was diagnosed.
If no abnormalities are found, people should have a screening every 10 years if they have no family history of the condition.
For those with a family history, a new genetic test called an oncotype dx test can help determine if they have inherited certain genes so the appropriate precautions can be taken, Makoni said.
Prevention
In addition to regular screenings, people can make lifestyle changes that help prevent colorectal cancer.
"There are strategies to prevent it, such as through diet," Makoni said. "People can avoid red meat, and add a lot of folic acid to their diet. People should avoid alcohol, smoking and processed foods. They should also get regular exercise."
"There is also an interest in herbal supplements lately," he added. "Cooking foods with ginger and tumeric have been proven to help reduce the occurrence of colorectal cancer."
For additional prevention, Makoni said, those with risk factors for developing colorectal cancer can take steps to minimize cyclooxygenase, an enzyme found in the bowels that can cause polyps and later cancer to form.
"Inhibiting this enzyme can help, through taking aspirin, and through taking Celebrex, though we're not recommending Celebrex at this time because it has been known to cause heart troubles," Makoni said.
Along with taking preventive steps, people should be aware of the symptoms of colorectal cancer.
"The presentation is usually variable depending on where the cancer is in the bowel," Makoni said. "But people can have tiredness or fatigue because of anemia, they might have a sudden weight loss, they can experience a change in bowel habits such as constipation or diarrhea, they could have blood in the stool or cramping."